2018 ICD-10-CM: Catch Up on These Ob-Gyn Coding Updates

Your ob-gyn practice faces a host of ICD-10-CM changes that affect how you code your services. You’ll find more specific codes for antenatal screening and be able to specify quadrant when coding for an unspecified lump in the breast under N63. Here are some of the ICD-10 changes you’ll want to note for your specialty:

Start Using These New Specific Antenatal Screening Codes

For those awaiting for a more specific code for antenatal screening, there’s good news. Effective Oct. 1, the code Z36 makes way for 17 new specific antenatal screening codes: Z36.0, Z36.1, Z36.2, Z36.3, Z36.4, Z36.5, Z36.81, Z36.82, Z36.83, Z36.84, Z36.85, Z36.86, Z36.87, Z36.88, Z36.89, Z36.8A, and Z36.9. This change will help you identify what the screening is for — such as Strep B (Z36.84) and nuchal translucency (Z36.82).

Look to Expanded Codes for Tubal & Ovarian Pregnancy Codes

Tubal and ovarian pregnancy codes now expand so that you can identify the side affected. You’ll choose the code structure O00.101, O00.102, and O00.109 in place of O00.10, O00.11, O00.20, and O00.21. Your ob-gyn will now need to document where anatomically — left or right side — the tubal or ovarian pregnancy is occurring.

Make Note of New Codes for Fetal Heart Abnormalities

Thanks to the latest changes, you can now report maternal care for abnormalities of the fetal heart rate or rhythm, specific to the trimester and fetus involved. You’ll look to new subcategory for this — O36.83-. Before this, you had only a code — O76 — that addressed this issue during labor and delivery. Note: The new code O36.83- requires sixth and seventh characters.

Use Expanded Breast Lump Codes

The latest ICD-10 code set adds new codes with fourth and fifth-digit specificity based on laterality and breast quadrant. The code N63 (Unspecified lump in breast) has been expanded to include codes for both the right and left breast. You will have the choice to incorporate codes for lump, mass, or nodule diagnoses relating to the axillary tail and subareolar areas of the breast: N63.0, N63.1-, N63.2-, N63.3-, and N63.4-.

Don’t Forget These New Codes & Revisions for Ob-Gyn

Make sure you keep a tab on the other updates impacting your ob-gyn practice to steer clear of denials. Unless someone points these out to you, it’s likely you may miss out on these updates, scattered here and there. For one, there are some encounter code revisions and additions — the descriptor of Z31.5 will change from Encounter for genetic counseling to Encounter for procreative genetic counseling. Plus, add these new codes to your coding armory — Z40.03 and Z71.83 and make a note of minor change in your BMI – for patients with a BMI of 19.5, report Z68.1 instead of jumping to the next code up.

At the same time, you’ll need to pay attention to a new counseling code Z71.82 and a revision to hormone therapy revision.

And there’s more!

We could only touch the highlights of the changes affecting ob-gyn — there are other changes that might impact your practice. Stay tuned to Ob-Gyn Coding Alert, a monthly newsletter by ob-gyn experts, for more ob-gyn coding guidelines, updates and insights.